Abstract [en]

Previous research has shown that about 30% of adolescent girls and 15% of adolescent boys suffer from disordered eating (DE) which can be defined as problematic eating below criteria for eating disorders according to DSM-V (Hautala et al., 2008; Herpertz-Dahlman et al., 2008). Even sub-clinical unhealthy weight-control behaviors have predicted outcomes related to obesity and eating disorders five years later (Neumark-Sztainer et al., 2006). However, two issues question the validity of DE. First, in contrast to eating disorders, under- or overweight/obesity are not necessary parts of DE. Second, some symptoms and correlates of DE are similar to those of depression. E.g., parent-adolescent relationships seem to play an important role in explaining both DE (Hautala et al., 2011; Berge et al., 2010) and internalizing problems (Soenens et al., 2012). Thus, this study examined associations between DE and a wide range of internalizing and externalizing problems, parent-adolescent relationship characteristics, and food intake and sleep habits in a general population of adolescents. Comparing results with and without controlling for depression reveals whether DE is a specific problem or merely a depressive symptom. This study also explored whether DE and the other variables under study are associated independently of weight status (underweight, overweight/obesity, and normal weight), specific to under- or overweight, or spurious if taking weight status into account.

The study is based on the first wave of an on-going longitudinal study, and all measures are child-reported (N=1,281). Adolescents attending grades 7 to 10 in a Southern Swedish municipality (age 12.5 to 19.3, M = 15.2, SD = 1.2) filled out questionnaires in class. DE was measured using the SCOFF, a five-item screening scale validated for use in general populations (e.g. Muro-Sans et al., 2008; Noma et al., 2006).

The results of univariate ANOVAs indicate that associations with DE were largely independent of weight status. Moreover, most associations with disordered eating were spurious when controlling for depression. However, some associations remained. Above and beyond depression effects, adolescents with DE reported lower self-esteem, stronger feelings of being over-controlled by their parents and active withholding of information towards them, consumption of fewer meals during the week, and higher levels of daytime sleepiness. Boys with ED slept more hours during the week and ate more fruits and vegetables than boys without ED. In conclusion, despite an overlap between depressive symptoms and disordered eating, this study provides ample evidence that sleep, nutrition habits, self-esteem, and parental control issues distinguish eating disordered adolescents from those suffering from general depressive symptoms.